The present invention relates to an ankle joint bandage of elastic bandaging material having a tubular configuration. The complicated ankle joint forming part of the supporting and musculoskeletal system is exposed to great impact and compressive strains. Excessive straining within this region can quickly cause traumatizations of the soft tissue. Supination traumata due to violent overstretching of the ligaments while the foot is stationary or in the case where a sudden twisting of the lateral border of the foot takes place frequently leads to injuries of the ankle joint. In this connection damage occurs assuming different forms and harbours the risk of posttraumatic arthrosis.
In sports medicine, after the knee joint, the ankle joint is considered to be the second most frequently affected injury region. Fractures and lesions of the ligament of the upper ankle following distorsions or ankle strain are the most frequently occurring articular injuries in man in general.
Within the region of the foot, a distinction is made between the upper and the lower ankle joint. The close interaction of the two as well as a functioning capsula-ligament system are the prerequisite for the functional capability of the ankle. The upper ankle, in the form of a hinge joint, only permits extension and flexion movements. Tibia and fibula embrace in a pincer-like fashion the articular trochlea (trochlea tali) of the ankle and form the mortice. The inner and the outer collateral ligaments provide additional stability. The ligaments are fanned in their advance movement structure so that--in every position assumed by the joint--a part thereof is stretched each time.
The lower ankle has an extended motional play and permits rotary motions about an oblique axis directed from laterally behing downwards to medially at the front towards the top so that it makes the pronation and supination of the foot possible. Since the ankle bone rests upon the heel bone, one differentiates between the anterior and the posterior lower ankle which closely interact in a functional way. The gap between navicular bone and heel bone is closed by the socket ligament. In the musculature of the foot, a differentiation is made between muscles having primarily static tasks and muscles which primarily serve for the locomotion. It is the important function of the musculature to protect the joint from the forces acting on the latter.
The tricipital peroneal muscle (musculus triceps surae) which is composed of the gastrocnemius muscle (musculus gastrocnemius) and the soleus muscle (musculus soleus), participates in the plantar flexion. The long flexor digitorum longus muscle (musculus flexor digitorium longus) additionally supports the plantar flexion in the upper ankle joint and, in the lower ankle joint, takes part in the pronation. It supports the longitudinal arch of the foot. The posterior tibial muscle (musculus tibias posterior) supports in the upper ankle joint the plantar flexion and, in the lower ankle joint, the supination. The muscular insertion is located at the highest point of the arch of the foot, it being responsible for the longitudinal excurvation of the same. Besides, the flexor hallucis longus muscle (musculus flexor hallucis) is involved in the upper ankle joint in the plantar flexion. It runs through below the bony prominence of the ankle bone and thus counteracts the dislocation of the heel bone. The muscles of the front of the lower leg, in the upper ankle joint on the dorsal extension, participate in the lower ankle joint in the pronation. The extensor hallucis longus muscle (musculus extensor hallucis longus) and the extensor digitorum longus muscle (musculus extensor digitorum longus) for oart of this. Apart from this, the anterior tibial muscle (musculus tibias anterior) supports the arch of the foot. The peroneus longus muscle (musculus peronaeus longis) proceeding laterally on the lower leg and the peroneus brevis muscle (musculus peronaeus brevis), have, in the upper ankle joint, a plantar-reflective effect and, in the lower ankle joint, a pronating one. The Achilles tendon is composed of the tendons of the musculus gastrocnemius and the musculus soleus. As the thickest and stringest tendon of the body it extends from the lower third of the calf to the heel bone. Its osseus attachment is located on the distal half of the tuber calcanei, where it fans out broadly towards medial and lateral.
From the DE-A-38 40 714, an ankle joint orthosis is known which comprises a U-shaped supporting stirrup whose legs converge below the foot into a web, extend beyond the ankle and, within their terminal area, are held together by a fastening strap. The outer leg is directed laterally in front of its ankle, and the inner leg, in comparison with the outer leg, is directed upwardly in front of the Achilles tendon. The legs are directed in the direction towards the web up to a position in front of the heel and proceed upwardly in the direction towards their ends in such a way that they, laterally next to the tibial edges, make their way approximately parallel to the same. Within the lower area of the legs, a retaining strap, more particularly a cling or Velcro strip, is fitted which proceeds from the one leg across the instep obliquely upwards to the other leg so as to be securable to the same, above the ankle it engages around the Achilles tendon and, on the instep, crossing itself, it terminates at the other leg in a retaining member.
With an ankle joint orthosis constructed in this way it is intended to prevent a twisting of the ankle above all in the lateral front direction, thus in the direction towards a drop foot position.
The DE-U-G 85 03 139.9 relates to an ankle bandage which consists substantially of a tubular section adapted to the anatomy of the ankle joint, in which the area to be allocated to the Achilles tendon is provided with a padding insert which possesses a high degree of cushioning effect and of an elastic recovery capacity. The padding insert itself may consist of plastic possessing a great elastic recovery capacity and a good deformation resistance, fabricated by way of example of polyform. With the aid of such an ankle bandage it is intended to protect the Achilles tendon; at the same time it is intended to ensure a fixation of the protective device.
The DE-A-38 38 582 describes an articular bandage of tubular knit constructed in the form of a joint-covering, elastic ankle sock, in which the shape and size are anatomically adapted to the ankle to be bandaged. A U-shaped stirrup insert is integrated into the ankle sock in the style of an antagonistic loop which is spirally entwined by a support laid around the ankle, the support, in the form of an inelastic strap, is laid with its windings spaced apart from each other and starts and terminates on the outer leg of the stirrup insert. An ankle joint bandage constructed in this fashion is intended to stop physiologic torsional, shearing and tilting motions and to render possible a safe as well aa adjusted functional sequence of movement in the ankle joint. In this case the bandage is intended to fulfil substantially three functions for the ankle joint, viz. protection, stabilization and sportiveness.
For the support of relaxed arches and for an insufficient muscle and ligament stabilization of the human foot, the DE-A-34 41 496 provides a device consists of a sock fitting tightly to the foot, on whose inside or outside an elastic is attached in such a way that it can be led back approximately obliquely below the sole of the foot across the instep to the fastening side and, with its free end, can be fixed to the same while, on to the inside and outside of the sock, a strip of inelastic material is sewn, on which it extends from the upper end of the sock to the vicinity of the sole of the foot. It is intended to achieve with such a device a supporting effect that corresponds to the natural muscle tractions, as a result of which, depending on the tension of the elastic, a continuous and progressive relief of the individual arches is possible. It is intended, moreover, that the device is independent of shoes and thus renders possible a permanent use even at night.
The DE-A-39 24 428 describes a support for the ankle joint region, more particularly for the lateral support of the lower ankle joint with a supporting member which is open at the front of very largely rigid material embracing the posterior region of the foot as well as laterally embracing a portion of the lower leg and constructed in the form of a boot-like partial shoe, in which, in the supporting parts, at least within the region of the ankle, an indentation and, adjacent to the front opening, closing elements are provided. In order to achieve an improved lateral support stability, in said supporting means, the area of the partial shoe located between the front edge and the ankle indentation, is discontinuous. In addition, this frontal area of the partial shoe is provided with two tabs. By means of this discontinuance provided in the supporting means it is intended to ensure that, particularly when walking with the supporting means, occurring compressive and tensile stresses of the front of the supporting means are reduced and fatigue ruptures are thus avoided.
In the known supporting means for the ankle joint region, one proceeds in part from the boot-like partial shoes, from elastic ankle socks or tubular bandages which, for the lateral support of the ankle joint, are provided with padded inserts, supporting strips, stirrup inserts or specially constructed supporting brackets in order to laterally support and stabilize the ankle joint. None of the known supporting means or articular bandages is constructed in such a way that a deep-acting transverse friction on the Achlles heel attachments is achieved. A combination of a friction massage involving a massage of the soft tissue is achieved is not achieved with any of the known supporting means or bandages.